The Heart Doctor and the Baby (12 page)

She went still, narrowed her eyes. “Single-handedly? I think I was in that bed, too.”

He let go his breath. “The thing is—”

“Jon.” She rose and walked up to him, close enough to feel her breath as she whispered. “The contract is in place. We can step back and think things through, if you'd like.”

“Yes,” he said a bit too quickly. “Yes, I think that's a good idea.”

He thought he saw something flicker in her eyes. Hurt? Disappointment? Before he could explain more she gestured toward her desk. “Now if you don't mind, I've got a stack of paperwork I've got to get done so my patients can get continuity of care when I'm off on maternity leave.”

That was it? She'd dismissed him?

“I'm really sorry,” he said, “if I've messed things up.”

“Not a problem,” she said, her usual warmth replaced with a prickly facade. “Really.”

Their incredible night of love had been sliced down to a mere “oops” moment. No problem, she'd said. Except it was a problem, a monumental problem. Jon Becker didn't get involved with or make love to a woman unless he cared about her.

He stood there for a few seconds as her tone shifted from tolerant to get lost, and he knew he'd fouled up even more than he'd imagined.

As Jon left her office a confused ball of tension, he glanced at his watch. If he hurried, he'd have time for another run during lunch.

 

Friday was René's office baby shower. He'd thought about skipping the party and delivering his gift in person at her house over the upcoming weekend, as another excuse to talk to her privately. He needed to straighten things out between them. But it would be so obvious if he didn't come to the party today. Everyone else would be there.

The medical clinic closed two hours early every other Friday and today was deemed the perfect day to have her baby shower. Claire was in charge and had gone all out,
decorating and planning the menu and baking the cake. Jason looked on with pride as she fussed over the finishing touches.

Jason's gaze stumbled on Jon. He gave that knowing man-to-man look. “It's payback time,” he said.

“Huh?” Jon's IQ had virtually disappeared since falling for René.

“You know, René hosted the baby shower for Claire, now its payback time.”

“Ah.” Jon nodded, and swallowed against the permanent dry lump in his throat. “I guess I'd better go get my gift,” he said, and disappeared to his office.

An hour and a half later, Jon stood at the outskirts of the ring of office employees who cooed and fawned over René, who was queen for the day.

He'd almost had to sit down and catch his breath when she'd removed her doctor's coat and revealed another, even sexier, sundress beneath. The halter-top cut enhanced her shape, and the bright patchwork pattern of orange, dark pink, gold and brown brought out her olive coloring and made her hair look auburn. To say she was stunning would be an understatement. She blew his mind with beauty, and he was almost certain she'd dressed this way to taunt and get back at him. By the rapid-fire beat of his pulse, she'd achieved her goal with little effort.

He ate his raspberry-filled white cake and did his best to act nonchalant when she chose his huge box to unwrap. Claire gave him a knowing glance, since he'd given her and Jason the same gift. Yeah, it was uncreative but functional, and the medical clinic partners had grown to expect no less of him.

But he'd gone one step further with René. She read his bland card without expression, then swept her thick-lashed
eyes over him and thanked him with an undecipherable nod. Her smile was reserved, her beauty riveting.

She tore off the wrapping paper and gasped. “Jon, this is fantastic! Thank you.”

From a safe distance across the room, and with a schooled expression, he said, “You're welcome.”

He'd given her an all-terrain stroller. René was almost positive there was a message buried somewhere in there, but she'd been known to read into things, and often the results had been disastrous. All-terrain meant the stroller was built for all surfaces, all speeds. The hills and valleys of Santa Barbara could be explored either walking or
running.
He knew she wasn't a jogger, yet here was this special stroller.

She flashed on Jon running behind the stroller, pushing their baby along on his daily run, then stopped cold. She could become addicted to thoughts like those, and after Jon had done everything but run out her door yesterday morning, she couldn't allow one more fanciful thought about Jon Becker to sneak into her mind. It wasn't in the contract.

He'd made it beyond clear that they'd made a mistake and it would never happen again. But he did deserve a personal thank-you. He'd given her a great gift—actually, two great gifts. She patted her pregnant belly. The least she could do was be gracious.

She waited until most of the staff had left. Jason and Claire were packing all of her gifts into the back of their new van and wouldn't let her help, so she took the opportunity to slip down the hall to Jon's office.

He'd nearly broken her heart by taking off so fast the other morning. They'd crossed over the line and blurred the set-in-stone verbiage of her carefully drawn contract
when they'd made love. She hadn't been thinking straight since.

He'd been attentive and considerate, an incredible lover, the kind of man that sent a woman dreaming about the future, and a lifetime together. There was no doubt in her mind he'd been as turned on as she'd been, but had it changed his feelings about her, too?

He'd said it had been a mistake, every last bit of it, that they should both know it, and it had cut down to the bone. He'd said as much again yesterday in her office. She'd tried to cover for the heartache, but even now, even after losing sleep hashing and rehashing the status of their relationship, she wasn't so sure he'd meant it. Maybe her foolish and fanciful thoughts had made her blind, but her feelings had changed toward him. She'd fallen in love. It was the last thing she'd planned on happening, but it had. The thought made her knees wobble. How could she keep him from catching on?

On the other hand, how could he change his mind about her if he didn't have a clue how she felt? Around and around she went, not knowing what she'd say when she actually saw him, though knowing full well it was best to keep her change of heart close to her chest.

After all, she needed to protect herself and the baby.

He wasn't at his desk, so she decided to leave him a note of thanks. She found a pen and paper, then noticed his screen saver—a picture of proud papa between two gorgeously dressed young ladies. Those tasteful yet flirty soiree dresses she'd helped pick out must have made him burst with pride when he'd seen his daughters in them.

I'm really looking forward to my freedom,
she remembered him often saying.

Regardless of how many hidden messages she imag
ined in his gift, she couldn't ask him to start all over again as a father. It wasn't in their original deal, no matter how much she wanted him to change his mind. And she couldn't exactly will him into loving her.

A travel brochure on China held a prominent position on his desktop. Oh, God, could she ask him to give up that trip, too?

Her gaze drifted to a letter next to the brochure with a well-known university letterhead logo at the top.
We look forward to meeting you at the job interview on…

She stared in shock at the first sentence. He really didn't want to be involved with her, not if he was planning to leave the clinic. She'd been such a fool to allow such fanciful thoughts. After the sperm donation, she should never have let him near her again.

Someone cleared his voice. It was Jon, standing in his office doorway. She couldn't let him know how foolish she'd been to fall for him, how completely out of touch she'd gotten with the original plan. She couldn't let him see her heart shatter. She reached somewhere deep inside and found her composure.

“Oh, hi,” she said. “I was going to leave you a thank-you note.” Could he hear the quaver in her voice?

“I was helping Jason get squared away with all the loot. You really made out today.” Did he need to sound so casual?

“I did, didn't I.” It was her turn to clear the fullness in her throat. A stealth pang of emptiness struck so hard she could barely breathe, but she couldn't let him know. He must never know her real feelings. “I wanted to tell you how fantastic that all-terrain stroller is. Tumbler and I will get lots of use out of it.”

He closed the door and took a few steps toward her, a tentative expression on his face. “I don't want you to get
the wrong impression.” He searched the corners of the room as if to find the best words, and she got the distinct impression he wanted to let her down easy. Damn him.

His hesitation and avoidance of tackling their problem head-on infuriated her.
Come out with it. Tell me you don't want anything to do with me. Tell me you don't care about me. Don't let me stand here loving you, when you can't return it.
Heat burned the tips of her ears and the room dimmed. Humiliated, all she wanted to do was save face.

“You think you took advantage of me?” She didn't care if his nurses might be around and could hear through his door. Gossip had been running rampant over who the father of her baby was. “I was as much responsible for what happened between us as you were, so don't give yourself so much credit,” she said, sounding harsher than she'd meant, but her emotions had taken over. Before she could break down in front of him and let slip that she'd fallen in love, she charged past him and out of the room.

She'd been stupid enough to think he might have feelings for her. He sure could have fooled her by the way they'd made love, but he'd already been planning to change jobs, and hadn't even bothered to mention it during their casual chatter between the bedsheets.

Nothing made sense. Her love. His aloofness. Their lovemaking. His withdrawal ever since. None of it. But right now, the part that hurt the most was that he let her leave his office without so much as a touch.

 

The next Wednesday night he showed up at her door when she was on her way out. “What are you doing here?” She faltered over the sudden pop of adrenaline circulating through her. To make matters worse, Tumbler jabbed her ribs with an elbow or heel.

“It's Wednesday, the final birthing class, right?” Jon said.

Damn, why did he have to make everything so difficult? She wanted more than anything for things to go back to the way they'd been, but it was impossible. Not with the feelings she'd been carrying around for him since they'd made love. Her initial anger had cooled off a bit, but the disappointment had cut deep and still festered.

“I relieve you of duty,” she said, with a huff and a single shoulder shrug. It took everything in her power to act and sound blasé. Her lower lip quivered, so she caught it between her teeth.

“Nonsense. I said I'd be your coach, and I have every intention of fulfilling my promise.”

She ignored the hurt expression on his face, focused on the cold phrase, needing desperately to hang on to her anger.

“I'm an independent, modern-day woman. I don't need you. I'll have a nurse help me when I deliver.”

“You know as well as I do those L&D nurses have four other patients assigned to them, and you'll wind up going through lots of contractions alone. I'll help you.” He made a solid point, but she brushed it off with another shrug. “This is nuts,” he said, sounding exasperated and scraping fingers through his hair.

With the last of her resolve she used her strident voice. “Maybe, but it's what I've decided.”

“I'm not going to let you give birth—” he stalled for a second; did he stop short of saying
to our baby?
“—alone.”

Her mother used to chide her impulses with an old saying, “Be careful what you wish for.” Well, she'd gotten exactly what she'd wished for, a baby of her own, and she was ecstatic about it, but the rest of the grief, the falling
in love with the sperm-donor part, she could never have imagined. Check another one off for Mom.

Jon frustrated her so much—being everything she could dream of in a partner, yet refusing to commit—she could scream.

“You're driving me crazy, you know that?” she said. “You want to be involved, then you don't want to be involved, then—”

“Ditto on the driving me crazy bit,” he said, grabbing her elbow as if saying the conversation was over. “Now let's go.”

“No!” She shrugged free. “And besides, tonight is that stupid last-class party. I'm not going,” she said.

“Then why are you holding a tray of canapés?”

She shoved two of them into her mouth. “Becauth I'm pwegnant and alwayth hungwy, thath why!” She slammed the door in his face.

Thirty-four weeks' gestation, early October

R
ENÉ
sat at her desk. She hadn't bothered to turn on the light. Early afternoon autumn shadows dappled her office walls, causing a bleak effect. Normally she loved the lacy silhouettes dancing like fairies around the room, but today they only emphasized an expanding pit of loneliness. Something vital had gone missing from her life. Jon.

She wished she could say things had gone back to normal after she slammed the door in Jon's face seven weeks ago, but the word
normal
no longer applied.

With chin cupped in palm, elbow anchored on the desk, her eyes darted around the room, deep in thought. As always these days, her other hand rested on her bulging stomach.

She was a soon-to-be single mother, who'd thought for sure she knew what she was doing when she'd succumbed to the lure of wanting a baby on her own. She didn't regret it. Not that part. No, being a parent promised to fulfill her life in ways she couldn't begin to fathom.

The nursery was completely ready with each tiny item of clothing, blankets, sleepers and T-shirts laundered and neatly folded and in their place. Jon had done a wonder
ful job of painting, the bright yellow walls were far more agreeable than that god-awful purple Gretchen had talked her into. Really, what had she been thinking?

René could ask herself that—what in the world had she been thinking?—about a lot of things. And one major thing in particular—the decision to ask a friend and coworker to be the sperm donor. Jon had been partially right when he'd accused her of wanting a designer baby, but truth was she'd love this kid no matter how things turned out. Smart, average, fat, thin, pretty, plain—none of that mattered. The love she felt inside for this child transpired every superficial characteristic life could throw at her.

In retrospect, yes, she should have stayed with a sperm-donor clinic, but knowing a part of Jon would always be in her life brought her a minute amount of selfish comfort. And she longed for more of it.

She never could have believed how much support he would be. And how empty she'd feel without him. When she'd made her original plans she'd only known Jon as a smart man, one she admired, the kind of man who would have good DNA. Along the way, she'd learned how wonderful he was, how witty, capable, warm and caring he could be. How he appealed to her on so many different levels, and yes, that he was a fantastic lover, too.

But they'd signed a contract; he'd fulfilled his role, and had big plans for his future. She was stuck in love and in limbo.

She hadn't planned on falling in love with him. She'd only planned on having a baby.

Jon had obviously taken her message about staying out of her life to heart and had left her alone since the day of her last birthing class. He'd also taken a couple weeks'
vacation in early September to get Amanda situated back east at the university, and, she feared, to interview for that job offer she'd seen on his desk.

When they occasionally ran into each other in the clinic, they were civil but distant, and the loss of his friendship had left a gaping hole in her core. She missed him so much. So far she hadn't found a way to forget him. How could she, carrying his child, feeling it move and grow inside her, knowing it carried his genes and dying to find out what the baby would look like?

René toed off her bronze-colored flats and let go a sigh of relief. She drew circles in the air with her toes, then elevated her feet on the adjacent chair.

When she thought about names, she wanted Jon's input. What was his grandmother's or mother's name? Did he have a favorite guy name? Did he like traditional or modern-sounding names? She stopped herself. The baby belonged to her and her alone. She had a contract stating as much, and he'd agreed to it. So why did it matter what his view on names was? And why couldn't she get that through her hormonally infused head when she'd found out from Claire that his middle name was Evan! She hoped her baby was a girl so she could name her after her mother, Yvonne. But if it were a boy…

After next week, she'd be on maternity leave and wouldn't have to deal with running into him or hearing his voice across the clinic, or noticing how fantastic he looked in his suits with the quirky added touch of sneakers. Or remembering how his hands felt on her body when they'd made love, and making love was exactly what it was, no one could convince her otherwise. They hadn't merely had sex to relieve some feral itch. No. They'd swept each other into the living, feeling truth of the matter; they'd
opened up and held nothing back. She knew she'd touched his soul, could feel it when Jon had been inside her and his pearly black eyes delved into hers, and his expression had taken her breath away. He couldn't disguise that “deep into you” stare, and she'd felt it to her trembling core.

Her watch alarm went off. She checked, then silenced, it. Quiet time was over whether she was ready or not. Back on with the shoes. Another sigh and push off from her desk to help her stand. She took inventory of her office with faint silver strands of light fighting off the lengthening afternoon, and losing. The tone paralleled her mood; she shook her head.

She hadn't meant to highjack Jon's plans. He deserved his freedom, his trip to China; he'd talked about it from the beginning. He'd lived up to his part of the bargain, and she needed to step aside to let him live the rest of his life.

Instead of sighing, she let out a quick breath through her nose and chided herself.
You made the rules, kiddo.
So why was she so lonely and so damn mad at him?

In the meantime, she had more patients to see, and her feet ached from carrying all the extra weight around even though she wore natural-fitting shoes for support. She'd started to waddle, and had hit the always-searching-for-comfort-but-never-finding-it stage. When she looked at herself, all she saw was her belly, and lots of it. How could she possibly grow any bigger?

She blew out a breath and her hair lifted from her forehead. September was almost over, and October traditionally was a hot month in Santa Barbara. Since she was hot all the time now, at this size, how would she get through the coming month?

About to open her next patient chart, her intercom line buzzed.

“Dr. Munroe, it's Gaby. Is it okay if I add on one of your patients this afternoon?”

“I think I can squeeze someone in. Who is it?”

“Lisa Lightner—she's on the phone now,” Gaby said.

Lisa was due to deliver her first baby in three weeks, and she'd had a smooth pregnancy up to now. They'd often exchanged pregnant anecdotes with each other, and had developed a special bond because of it.

“What's wrong?”

“She didn't really say, just that she doesn't feel right.”

A flashing yellow light blinked in the back of René's mind. Lisa wasn't a complainer or a hypochondriac; if she thought something wasn't right, René knew she should look into it.

“Tell her to come right in, and let Amy know.”

Forty-five minutes later, a very pregnant Lisa sat on the exam table making René feel small in comparison.

“What brings you in today, Lisa?”

“I feel like I can't catch my breath.” She punctuated her words with shallow gasps.

With her uterus pressing on her diaphragm, René knew it was a common complaint, yet she took her pulse, which was rapid, and listened to her lungs and breath sounds, which were also fast, though her lungs sounded perfectly normal. Her blood pressure was mildly hypotensive, but within her normal range.

“Any chest pain?”

“I wouldn't call it chest pain. I just don't feel right.”

“We'll get an EKG to rule anything out. Have you had any unusual leg pain or injury recently?”

Lisa shook her head. From her history, René knew Lisa had never had coagulation problems, but pregnancy could sometimes pull some pretty hairy cats out of the bag.

To be on the safe and thorough side, René examined her patient's lower extremities, and though no varicose veins were present, she did locate one tender area on the back of Lisa's calf beneath a small bruise. “I'm going to order a D-dimer blood test, and if it's positive, we'll do an ultrasound of your leg to rule out deep vein thrombophlebitis.”

“What's that got to do with being out of breath?”

René didn't want to scare Lisa, but if she did have DVT, a pulmonary embolism could be the cause of her shortness of breath. There was no way she'd tell her that; though rare, pulmonary embolism was the leading cause of maternal mortality during pregnancy and up to six weeks postpartum.

“It's just a precaution, Lisa. I need to rule out all the possibilities before I make my diagnosis. Your lungs sound normal, no crackles or wheezing, so that's good. Let me have my nurse check your oxygen saturation and do that EKG before you go to the lab. We'll figure this out before you leave today, I promise.”

Making a diagnosis of pulmonary embolism in a pregnant woman was a tricky task due to the tests required and concerns about fetal radiation exposure.

“I'd like you to stick around while we wait for your STAT lab results.”

Lisa nodded, and René waddled off to see her next patient, but her mind stayed on Lisa. She wanted to discuss the case with Phil, the pulmonary doctor in their practice. After she'd seen the other patient, she called Phil's office, but he wasn't there.

When she inquired where he was, her nurse, Amy, told her it was his morning to do bronchoscopies at the hospital. She knew that. Her memory seemed to have shrunk in direct proportion with the growth of her
abdomen. René lifted her phone receiver to call Jason, the family practice guy in the group, then remembered that after Jon had come back from vacation, Jason and Claire had left on theirs.

That left Jon, the person she'd dodged for the past month. The person she was trying her hardest to forget and get over. Patient well-being trumped her personal concerns, so she walked to the back of the mansion-turned-clinic to find him in his office.

He was on his way out, focusing on a report and heading for his closest exam room. “Oh,” he said, when he noticed her, his pupils briefly widening, then going back to normal.

“Can I run something by you?” she said, itchy with discomfort and confusion at being so close to him.

“Of course.”

She gave him the thumbnail sketch on Lisa. She refused to look into his dark stare and, instead, she noticed the intricate geometrical interlocking pattern on his forest-green tie.

Before she could finish with Lisa's history, Amy rushed up. “It's positive. The D-dimer is positive.”

René thanked her. “Have you done the EKG? Oh, and put her on oxygen before you call for medical transportation to the hospital. She needs to go to the E.R. for an ultrasound of her leg and further testing.”

“You might want to get a normal saline IV going, too,” Jon said.

She and Jon stood in the hall and discussed the tricky situation of diagnostic testing for PE in a pregnant woman. They agreed the best test would be a ventilation perfusion lung scan, and if that proved indeterminate yet the clinical suspicion remained, pulmonary angiography would be a
necessary evil. She hated to put both mother and baby at risk, but knew something much worse could happen if they didn't treat a blood clot lodged in the lung. She worried about ordering a test for a pregnant patient that would involve radiation, even though in low quantities, but Jon pointed out the V/Q scan had the least radiation of any other diagnostic tests for PE.

Being able to discuss the medical possibilities with Jon was reassuring and she was grateful to have him here. She'd missed his knowledgeable input, but more importantly, his friendship. Maybe it was time to let him know exactly how she felt. Maybe after all this—

Before she could say a word, the interdepartment alarm went off. “STAT patient assist in first-floor waiting room.”

René's pulse spiked to where she could feel it in her temples. A sinking feeling had her praying it wasn't her pregnant patient. She and Jon rushed to the front of the clinic to find Lisa collapsed on the floor with a huddle of people around her.

Jon directed Amy to take over crowd control while he rushed for the crash cart. René went down on her knees beside the patient and felt for her pulse. Lisa was semi-conscious, and fighting for air.

“Get some oxygen over here, and call an ambulance. Gaby, call her husband and tell him to meet her at the E.R. Cough for me, Lisa,” she said, hoping the exertion might help break up any potential lung clot blocking her breathing. Lisa did as she was told, but with little effort. Once the oxygen mask was in place, René asked her to cough again, and she coughed a little harder.

“I'm afraid I'll wet my pants,” Lisa said.

Relief showered over René, and she grinned. If a patient was worried about wetting themselves, they couldn't be
too far gone. “You're going to be okay, Lisa. Hang in. We're going to get you to the hospital.” Hopefully it was a small clot that would resolve easily with treatment.

Jon and Amy lifted Lisa onto a gurney and they rolled her into the first-floor procedure room.

Jon inserted an IV, and René calibrated the patient weight and started the appropriate amount of heparin via piggyback into the IV. Because the drug didn't cross the placenta, it was the safest anticoagulant to use during pregnancy.

Jon stood by the crash cart with the Ambu bag in readiness, as Amy set up the heart monitor and pulse ox. The patient's vital signs were challenged but stable. And most importantly, her oxygen saturation was within normal limits.

The strain and fear evident in Lisa's eyes tore at René's heart. How would she feel in the same situation? Scared to death! She held Lisa's hands tight and leaned over her. “We're going to get you through this.”

“What about my baby?”